Healthcare Provider Details

I. General information

NPI: 1285453886
Provider Name (Legal Business Name): AMANDA HUA PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 10/09/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7146 EDINGER AVE
HUNTINGTON BEACH CA
92647-3568
US

IV. Provider business mailing address

7146 EDINGER AVE
HUNTINGTON BEACH CA
92647-3568
US

V. Phone/Fax

Practice location:
  • Phone: 714-377-4314
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number306818
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: